Migraine in Children

Migraine in Children

Are you concerned that your child might be suffering from migraines?  In this article Donna Ryan, Information Officer for Migraine Association of Ireland explains symptoms and gives tips to parents for managing migraines in kids.

Migraine Affects 1 in 10 Irish Children

“My mother told me that I was sick in the car when they took me home from hospital as a new born baby,” says life-long migraine sufferer Marie O’Riordan, “Over twenty years later a neurologist told me that this motion sickness I suffered from as a child was in fact migraine.”

Migraine affects 1 in 10 Irish children but is still both misunderstood and under-diagnosed.

“Diagnosis migraine in children is a difficult task,” says Donna Ryan, Information Officer with the Migraine Association of Ireland. “Migraine attacks in children do not always include a headache – the most commonly recognised symptom of the condition.

“Instead, children can present with a group of symptoms that do not include headache at all but range from stomach ache to dizziness to nausea and vomiting.”

This combination of symptoms is known as Childhood Periodic Syndromes.

Different Types of Symptoms and Syndromes

Abdominal migraine is one such syndrome. The pain can be dull, sore or intense and is usually located around the middle of the abdomen in the navel area. This pain can be accompanied by the more typical migraine symptoms including a throbbing headache, sensitivity to light, noise or smells and visual distortions.

More uncommon migraine symptoms such as fatigue, mood changes, loss of appetite, flushing, motion sickness and dark shadows under the eyes can also present.

Cyclical vomiting syndrome is another disorder which afflicts young children, particularly those in the age 3 to 7 bracket. It is characterised by recurrent, prolonged attacks of severe and unexplained nausea, vomiting and prostration. Vomiting occurs at frequent intervals – five to 10 times an hour at peak – and lasts from a few hours to 10 days. There is a complete resolution of symptoms between attacks and episodes tend to be similar in terms of symptoms and duration.

In toddlers, the most common syndrome is Benign Paroxysmal Vertigo. This consists of sudden bouts of vertigo and dizziness without hearing loss or tinnitus. The spells can last from minutes to hours and resolve spontaneously. Nausea, vomiting, visual disturbances and flushing can also occur.

The Difference Between Migraine in Children and Migraine in Adults

So what is the difference between migraine in children and migraine in adults?

“In adults a migraine attack can last for up to four days with a throbbing headache on one side of the head,” says Ryan, “However, in children, attacks are generally shorter – less than 24 hours – and the headache is likely to be present on both sides.”

A diagnosis of migraine will only be made after other medical conditions such as irritable bowel syndrome, inflammatory bowel disease, gastritis and intestinal blockage are ruled out.  

The exact cause of migraine is still unknown. Researchers believe that a number of parts of the body including the central nervous system, the brain, the blood vessels and the gastro-intestinal tract come together to bring about an attack. Levels of chemicals in the brain are also altered and attacks are usually sparked by exposure to one or more ‘trigger factors’.

Identifying and Avoiding Trigger Factors

“Children can reduce the frequency of their attacks by identifying and avoiding trigger factors,” says Ryan, “The best way to do this is to keep a migraine diary. The diary is used to record possible triggers – such as foods eaten, sleep patterns, events at school or at home, hobbies, exercise, weather and TV usage – for at least six attacks, the child may be able to identify a pattern and work out the trigger or combination of triggers that set an attack in motion.”

The migraine diary is especially important for children as the most common migraine specific medications – triptans – are not licensed for use in patients under 16.

When further management is required mild analgesics – such as paracetamol or ibuprofen – can be administered to children on the advice of a health professional. If nausea is a problem an anti-emetic can be taken to aid absorption of the medication.

For children whose migraine is frequent and debilitating, a preventative treatment may be considered.

Parents who are opposed to allowing their child to take medication daily – as required for preventative medications – or are unhappy with the side-effects, which can include drowsiness and weight gain, may turn towards self-help measures.

 “Let them lie down in a quiet, dark room and try to sleep. If there’s a headache, use hot or cold packs and apply light pressure,” says Ryan, “Parents should also ensure that their child gets plenty of fresh air, avoids watching TV for long periods of time, is adequately hydrated and maintains good posture when seated or standing. Some of the best ways to manage migraine in kids are the oldest and the simplest.”

To find out more you can call the Migraine Association of Ireland’s helpline on 1850 200 379. Alternatively, visit: www.migraine.ie

Or check out our youth websites at: www.migraineandme.ie or www.migra-zone.ie (teenagers)

MIGRAINE: THE SYNOPSIS

Symptoms

• Throbbing headache
• Upset stomach (nausea and/or vomiting)
• Sensitivity to light, noise and/or smells
• Visual distortions
• Mood changes
• Loss of appetite
• Flushing
• Dizziness
• Fatigue

Common Triggers

• Missed meals/irregular eating patterns
• Lack of sleep/over-sleeping
• Anxiety or stress factors
• Excessive physical exercise or lack of exercise
• Flicker from TV or computer games
• Hormonal changes
• Changes in weather
• Over-excitement

Self-Help Tips

• Know the signals (these include tiredness, hyperactivity, excessive yawning, food cravings, mood changes...) and act early
• Regularise sleeping patterns (including weekends)
• Keep hydrated
• Eat regularly
• Take regular but not excessive exercise
• Keep a migraine diary
• Ensure carers and teachers know and understand the child’s condition